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General NPI Number Information
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NPI Number | 1932196078
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Entity Type | Organization
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Legal Business Name | WINDSOR HOSPITAL CORPORATION
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Dates
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Enumeration Date | 10/04/2005
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Last Update Date | 12/04/2019
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Provider Practice Location Address
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Address Line | 289 COUNTY RD
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City | WINDSOR
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State | VT
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Zip | 05089-9000
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Country | US
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Telephone | 802-674-7036
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Fax | 802-674-7005
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Provider Business Mailing Address
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Address Line | 289 COUNTY RD
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City | WINDSOR
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State | VT
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Zip | 05089-9000
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Country | US
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Telephone | 802-674-7218
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Fax | 802-674-7005
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Authorized Official
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Title or Position | CFO
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Name | DAVID SANVILLE
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Credential |
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Telephone | 802-674-7240
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 703
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License Number State | VT
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